Falling through the cracks

May 01, 2002|By Mark Beardslee

GAYLORD - In the spring of 1998, the mother and stepfather of a mentally ill man in his 20s called Michigan State Police troopers from the Gaylord post to their home because he had slit his wrists in a suicide attempt. The two troopers took the man to a mental health facility, at which point one of the officers said, "You'd better keep him or somebody's going to get hurt." A few weeks later, the same troopers were called by the man's children, who said there had been gunfire. Inside the door, they found a woman dead of a gunshot wound. In the basement of the home, they found a man lying dead of a self-inflicted gunshot wound to the head. It was the same man they had saved from a suicide attempt just weeks earlier. The dead woman was his wife.

"You felt frustrated, you felt sick, nauseated, stressed and you felt that the mental health system had failed," said one of the troopers of the tragic incident that left six children without their parents.

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The troopers referred to in this article wished to remain anonymous, to protect their own privacy and that of the people involved.

The police often are the first on a scene when something goes wrong involving a mentally ill person - when a patient stops taking medication or when new symptoms arise. Unfortunately, police lack the legal authority and the medical expertise to sufficiently intervene. This reality leaves many police officers feeling frustrated because it can sometimes lead to what they view as preventable tragedies.

"As police officers," a trooper explains, "if we feel someone is a danger to himself or others, we can take him into protective custody for evaluation. But it must be an immediate danger. Unless he breaks a law, our hands are tied."

This summarizes the legal constraints police officers face when dealing with the mentally ill. Officers say they know from experience that a particular mentally ill person may at anytime present a threat to himself or others, but because of constitutional safeguards, they cannot just haul a person away without just cause.

Even when they do have such cause, the police know that once a person is turned over to a mental health facility, that person's future is in the hands of doctors. "I'm not a mental health professional," admits one officer. Yet, he says, "We run into people constantly who we feel should be institutionalized."

Dr. Andrew Sahara, a clinical psychologist and supervisor of emergency services at Northern Michigan Community Mental Health (NMCMH), indicates that the police can pick up such persons, place them in protective custody and have them evaluated. But, he says, the mental health community faces similar constraints as police. "We follow the mental health code for involuntary hospitalization," he says, adding that, just like the police, "we have to see imminent risk" to hospitalize someone. "And we have to see evidence of mental illness."

Alexis Kaczinski, director of NMCMH, says this approaches the area of civil rights. "What they're talking about," she says of officers who would like to see more institutionalization, "would remove liberty from a lot of people." She said mental health professionals are highly trained, primarily to provide treatment, but also to uphold the law. Staff cannot enforce or create that law, she asserts. As it stands, Kaczinski says when someone meets involuntary hospitalization criteria, legal due process - which often involves the courts - must be followed. "I don't have the power to force you to take medicine," she says. "You have the right to be mentally ill."

One trooper on the scene of the incident described above said he felt particularly frustrated because he and his partner had taken steps to get the man the treatment he needed. "We don't always take such extra precautions to make sure someone doesn't hurt himself," he says, indicating that on this occasion, the man was taken directly to a mental health facility rather than to an emergency room.

This trooper contrasts what law enforcement officers can do for the mentally ill with how they can deal with drunk drivers. In the case of the mentally ill, "We can attempt to make that situation for the time being safe, then it's up to the doctors." For drunk drivers, he says, the police know they are taking someone off the streets who presents a danger to himself and others and that they are keeping the individual in a secure location until he or she no longer poses that danger. He says they can never be sure when it comes to mentally ill persons.

The officers say problems with mentally ill patients arise when they stop taking medication or when it stops working as it is intended, or when the patient mixes it with alcohol or illegal drugs. Of a repeat offender who commits crimes because of a mental illness, the troopers ask, "What is six months in a county jail going to teach him?"